<?php
/* @var $this ExternalExamController */
/* @var $model ExternalExam */
/* @var $form CActiveForm */
?>

<div class="form">

<?php $form=$this->beginWidget('CActiveForm', array(
	'id'=>'external-exam-form',
	'enableAjaxValidation'=>false,
)); ?>

	<p class="note">Fields with <span class="required">*</span> are required.</p>

	<?php echo $form->errorSummary($model); ?>

	<div class="column">
		<?php echo $form->labelEx($model,'lids_od'); ?>
		<?php echo $form->textField($model,'lids_od'); ?>
		<?php echo $form->error($model,'lids_od'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'lids_os'); ?>
		<?php echo $form->textField($model,'lids_os'); ?>
		<?php echo $form->error($model,'lids_os'); ?>
	</div>

	<div class="column">
		<?php echo $form->labelEx($model,'conjunctivae_od'); ?>
		<?php echo $form->textField($model,'conjunctivae_od'); ?>
		<?php echo $form->error($model,'conjunctivae_od'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'conjunctivae_os'); ?>
		<?php echo $form->textField($model,'conjunctivae_os'); ?>
		<?php echo $form->error($model,'conjunctivae_os'); ?>
	</div>

	<div class="column">
		<?php echo $form->labelEx($model,'discharge_od'); ?>
		<?php echo $form->textField($model,'discharge_od'); ?>
		<?php echo $form->error($model,'discharge_od'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'discharge_os'); ?>
		<?php echo $form->textField($model,'discharge_os'); ?>
		<?php echo $form->error($model,'discharge_os'); ?>
	</div>

	<div class="column">
		<?php echo $form->labelEx($model,'lacrimal_od'); ?>
		<?php echo $form->textField($model,'lacrimal_od'); ?>
		<?php echo $form->error($model,'lacrimal_od'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'lacrimal_os'); ?>
		<?php echo $form->textField($model,'lacrimal_os'); ?>
		<?php echo $form->error($model,'lacrimal_os'); ?>
	</div>

	<div class="column">
		<?php echo $form->labelEx($model,'tbut_od'); ?>
		<?php echo $form->textField($model,'tbut_od'); ?>
		<?php echo $form->error($model,'tbut_od'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'tbud_os'); ?>
		<?php echo $form->textField($model,'tbud_os'); ?>
		<?php echo $form->error($model,'tbud_os'); ?>
	</div>

	<div class="column">
		<?php echo $form->labelEx($model,'schimer_od'); ?>
		<?php echo $form->textField($model,'schimer_od'); ?>
		<?php echo $form->error($model,'schimer_od'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'schimer_os'); ?>
		<?php echo $form->textField($model,'schimer_os'); ?>
		<?php echo $form->error($model,'schimer_os'); ?>
	</div>

	<div class="column">
		<?php echo $form->labelEx($model,'rx_id'); ?>
		<?php echo $form->dropDownList($model,'rx_id', CHtml::listData(
                Rx::model() ->findAll(), 'id','id'), array('prompt' => 'Select Rx')); 
                ?>
		<?php echo $form->error($model,'rx_id'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'Patient Name'); ?>
		<?php echo $form->dropDownList($model,'personalinfo_id', CHtml::listData(

		PersonalInformation::model() ->findAll(), 'id','fname', 'lname'), array('prompt' => 'Select Patient')); ?>

		<?php echo $form->error($model,'personalinfo_id'); ?>
	</div>

	<div class="row buttons">
		<?php echo CHtml::submitButton($model->isNewRecord ? 'Create' : 'Save'); ?>
	</div>

<?php $this->endWidget(); ?>

</div><!-- form -->